Therapeutic Theories Primer

For Marriage and Family Therapy

My therapeutic style will always be tailored to your specific needs and goals. Your treatment plan may include some or all of the following…

Object Relations

Object relations therapy emphasizes relationships as the primary motivational force in life, and assumes that family conflicts from early childhood help create a blueprint of how our "self-system" will develop and maintain relationships later in life. Object relations-based psychotherapy can often offer a deeper level of resolution by identifying and resolving the underlying causes of human conflict.

Object relations intuitively reflect certain truths about all human relationships — from the early relationships of infancy to friendships, marriages, and ultimately, the client-therapist relationship. "Objects" can be people (e.g., mother, father, friends) or things, such as transitional objects with which we form attachments. These objects, and the developing child's relationship with them, are incorporated into a self, and ultimately become the building blocks of the self-system.

We enter the world with a genetic blueprint that sets the stage for who we will become, but it's also our interactions with others throughout life that shapes how our genetic predispositions will be expressed. Early in life, we have little sense of ourselves, or our identity. It's through our relationships with those around us that we 'absorb' parts of others (objects) and slowly build a self-structure, which we eventually call a personality.

In childhood, we form relationships with our stuffed animals, toys and pets (transitional objects). Later in life, some of us form intense and even self-destructive relationships with food or alcohol, as well as with other people. The more traumatic our early self-object relations, the more rigid and resistant to change we become.

But the blueprint of self-structure can be modified. A therapist can help resolve old traumas and self-destructive relationship patterns, freeing us to mature and self-actualize. For example, we may distort our perception of potential spouses to conform to our internal image of an ideal mate; we may even try to manipulate them into conforming to our family template. But two years later, you may suddenly realize that you have no idea who your spouse really is, and you've reached a critical point in the relationship. You must now devote energy to breaking through the distortions and discovering each other, or decide to go your separate ways.

Psychodynamic Therapy

Psychodynamic psychotherapy is a form of "depth psychology" that explores the subtle or unconscious aspects of the human psyche in order to reveal unconscious conflicts and the defense mechanisms we use to avoid the unpleasant consequences of those conflicts.

Our views and perceptions of our past experiences are organized around our interpersonal relationships, including — and especially — our early childhood experiences. Psychodynamic psychotherapy helps develop insightfulness, and develop your ability to trust those insights to solve problems and cope with stress.

For example, Lacy has been trying for the past 20 years to be "popular." She packs her days with endless social engagements, spending very little time alone. She wonders why she feels so drained and disconnected from herself. We discover in our work together that her unconscious belief imposed by her family is: "I must constantly be with other people to be happy." She hadn't realized that she was basing the way she lived her life on that belief. As her self-awareness grew, she recognized that she is somewhat introverted, and actually feels more energetic when she creates space for time alone. As she changed her belief to "I am happy when I have enough space in my life just for me," she began to have more energy and experience more joy.

Cognitive-Behavioral Therapy (CBT)

Our thoughts, feelings and behaviors are inextricably bound: What we think and feel influences what we do. Through CBT, we can identify distorted thoughts and perceptions that lead to self-damaging and relationship-damaging behaviors. Once you can recognize distorted perceptions, it becomes easier to break bad habits and stop reacting to situations in destructive ways. In other words, by altering the thought process behind damaging behavior patterns, you can change the destructive behavior pattern.

CBT is a process of learning, exploring and testing that helps you acquire new coping strategies, as well as enhanced awareness, introspection and evaluation skills. CBT helps you process and control future thoughts and feelings, which ultimately reduces your reliance on therapy, and reduces the likelihood of relapse.

For instance, many people who are depressed can feel paralyzed by their negative thoughts and develop behaviors such as staying in bed, overeating, or watching TV. One technique that's helpful for some of my clients is to keep a journal and write down their negative thoughts. Often it's helpful to set it aside and do something to distract yourself (exercise, call a friend, etc). Then come back and read what you've written, see if you can look at it from an outsider's perspective. For example, what would you tell someone else who has the negative thought "I have no friends"? You might tell them to list the friends they do have. Often this technique can help people correct negative thinking patterns.

Journaling also helps you notice patterns that you can bring into therapy so that we can create new patterns and new ways of thinking. I often encourage clients to write a list of positive behaviors they can do when they feel depressed. For instance, calling a friend, going on a walk, petting an animal or taking a shower can all be positive behaviors, rather than passive ones. Performing a positive behavior (such as calling a friend) tends to increase your positive thoughts ("I have many friends who care about me").

Family Systems Theories

While I don't work directly with couples or families, my training in family systems theory as an MFT greatly Influences my work with individuals. Your family experiences deeply affect who you are. We are forever connected to our families, even if we feel distant or disconnected from them.

Families are interdependent: We connect to and react to the thoughts, feelings, and actions of other family members — almost as if we share the same "emotional skin." While families differ somewhat in the degree of interdependence, all family members need attention, approval, and support from each other. And they react to the needs, expectations, and distress of other family members.

Family systems theories suggest that each family is an emotional unit; individuals do not exist in a vacuum, and cannot be fully understood in isolation from their families. Changes in one person's functioning is followed by reciprocal changes in the functioning of others.

In families, each member grows up with a role to play and rules to respect. Each family member was expected to respond to the others in certain ways, based on her role. Maintaining the same pattern of behaviors within a system may lead to balance in the family system, but also to dysfunction.

For example, if a husband is depressed, the wife may be forced to take on some of his responsibilities to pick up the slack. While this role change may maintain stability in the relationship, it may also ultimately damage the equilibrium of the family dynamic. Over time, the wife may not be able to handle both her responsibilities and his. The children may feel neglected because Mom doesn't have enough energy to go around. The children may also begin to carry more of a load than they should which may begin patterns of caretaking and codepency that will show up in later relationships.